Flashcards in Other antidepressants Deck (16)
Other antidepressants - 5 drugs
Bupropion - MOA
Weak inhibitor of neuronal reuptake of DOP, NOR, SER at their transporters DAT, NET, SERT.
Noncompetative antagonist at nicotinic cholinergic receptors
Bupropion - indications
Adjunct therapy for smoking cessation
Bupropion - adverse effects
Agitation, insomnia, nausea, weight loss
Mirtazapine - MOA
Antidepressant and antianxiety effects. Blocks presynaptic alpha2-adrenergic autoreceptors and heteroreceptors, causing increased neuronal release of NE and SER respectively. Increases NE levels more than TCAs.
Potent antagonist of 5-HT2 and 5-HT3 receptors.
Mirtazapine - adverse effects
Significant elevation of hepatic enzyme levels
Trazodone - MOA
Selectively inhibits the neuronal reuptake of serotonin.
Antagonist at 5-HT2A receptors
Trazodone - adverse effects
Considerable sedation and orthostatic hypotension
Vilazodone - MOA
Selectively inhibits neuronal reuptake of serotonin. Also partial agonist of 5-HT1A receptors (accounting for anxiolytic effect). Enhancement of serotonergic activity in CNS
Tetracyclic antidepressant (TeCA)
Mood stabilizers - 3 drugs
Lithium - Indications
Manic phase of bipolar disorder
Lithium - MOA
Reduces both manic and depressive symptoms, but greater activity for manic phase. Suppresses the formation of second messengers involved in SER and NE neurotransmission. Reduces formation of IP3 by inhibiting myo-inositol-1-phosphatase. Interferes with formation of cAMP. Maximal response after days/weeks.
Lithium - adverse effects
Neurotoxicity, cardiac toxicity (dysrhythmias). Nausea and vomiting are the earliest signs of overdose.
At therapeutic dose: drowsiness, weight gain, fine hand tremor, polyuria. Hypothyroidism.
Lithium - interactions
Renal lithium clearance increases during pregnancy.
Sodium competes with lithium for tubular reabsorption increased excretion of lithium.
NSAIDs and diuretics increase serum levels.